Atypical Ductal Hyperplasia-Ductal Carcinoma In Situ Spectrum: Diagnostic Considerations and Treatment Impact in the Era of Deescalation
As the first node in treatment algorithms for breast disease, pathologists have the potential to play a critical role in refining appropriate therapy for lesions in the atypical ducal hyperplasia-ductal carcinoma in situ (ADH-DCIS) spectrum by conservatively approaching diagnosis of lesions limited in size on core needle biopsy. Appropriate efforts to downgrade the diagnosis of lesions at the borderline of ADH and DCIS will certainly lead to more breast conservation and avoid the common morbidities of mastectomy, sentinel node biopsy, and radiation therapy. Whether results of clinical trials of active surveillance will suc...
Source: Surgical Pathology Clinics - January 28, 2022 Category: Pathology Authors: Melinda E. Sanders, Mirna B. Podoll Source Type: research
A New Landscape of Testing and Therapeutics in Metastatic Breast Cancer
Predictive biomarker testing on metastatic breast cancer is essential for determining patient eligibility for targeted therapeutics. The National Comprehensive Cancer Network currently recommends assessment of specific biomarkers on metastatic tumor subtypes, including hormone receptors, HER2, and BRCA1/2 mutations, on all newly metastatic breast cancers subtypes; programmed death-ligand 1 on metastatic triple-negative carcinomas; and PIK3CA mutation status on estrogen receptor-positive carcinomas. In select circumstances mismatch repair protein deficiency and/or microsatellite insufficiency, tumor mutation burden, and NTR...
Source: Surgical Pathology Clinics - January 28, 2022 Category: Pathology Authors: Geetha Jagannathan, Marissa J. White, Rena R. Xian, Leisha A. Emens, Ashley Cimino-Mathews Source Type: research
Papillary Neoplasms of the Breast
Papillary neoplasms of the breast are a heterogeneous group of tumors characterized by fibrovascular cores lined by epithelium, with or without myoepithelial cells. Papillary neoplasms include benign, atypical, and malignant tumors that show varying histopathologic features and clinical outcomes. Appropriate pathologic classification is crucial to guide clinical treatment. Classification of papillary neoplasms is largely based on morphology, with immunohistochemistry playing an ancillary role to establish diagnoses. Recent molecular studies have provided insight into the genomics of these lesions. This review summarizes th...
Source: Surgical Pathology Clinics - January 28, 2022 Category: Pathology Authors: Dara S. Ross, Timothy M. D ’Alfonso Source Type: research
The Importance of Addressing Diagnostic Challenges in Breast Pathology with an Understanding of Current Clinical Treatment Implications
In this issue of Surgical Pathology Clinics, we present a collection of reviews focused on Breast Pathology, entitled “Diagnostic Challenges in Breast Pathology and Their Clinical Implications.” The topics in this breast pathology issue have been selected because of their relevance to clinical treatment. These are often challenging areas for the practicing pathologist, where subtle diagnostic differences can ha ve major clinical implications. In these articles, the invited breast pathology experts, often with their clinical colleagues as coauthors, not just explain diagnostic criteria and how to resolve differentials b...
Source: Surgical Pathology Clinics - January 28, 2022 Category: Pathology Authors: Kimberly H. Allison Tags: Preface Source Type: research
Metaplastic Breast Carcinoma Revisited; Subtypes Determine Outcomes
Metaplastic breast carcinoma (MpBC) is a heterogeneous group of tumors that clinically could be divided into low risk and high risk. It is important to recognize the different types of MpBC, as the high-risk subtypes have worse clinical outcomes than triple-negative breast cancer. It is important for the pathologist to be aware of the MpBC entities and use the proposed algorithms (morphology and immunohistochemistry) to assist in rendering the final diagnosis. Few pitfalls are discussed, including misinterpretation of immunohistochemistry and certain histomorphologies, particularly spindle lesions associated with complex s...
Source: Surgical Pathology Clinics - January 27, 2022 Category: Pathology Authors: Thaer Khoury Source Type: research
Bone Tumor Pathology
SURGICAL PATHOLOGY CLINICS (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - November 4, 2021 Category: Pathology Authors: G. Petur Nielsen Source Type: research
Copyright
ELSEVIER (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - November 4, 2021 Category: Pathology Source Type: research
Contributors
JASON L. HORNICK, MD, PhD (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - November 4, 2021 Category: Pathology Source Type: research
Contents
G. Petur Nielsen (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - November 4, 2021 Category: Pathology Source Type: research
Forthcoming Issues
Breast Pathology (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - November 4, 2021 Category: Pathology Source Type: research
Benign Bone-Forming Tumors
Benign bone-forming tumors comprise osteomas, osteoid osteomas, and osteoblastomas. Osteomas affect a wide age range and are usually discovered incidentally. They occur predominantly in the craniofacial skeleton and are classically composed of compact bone. Osteoid osteomas and osteoblastomas are painful lesions occurring in young patients. They are morphologically similar and characterized by FOS gene rearrangement and c-FOS expression at a protein level. Osteoid osteomas are usually smaller than 2 cm in maximum dimension with limited growth potential; osteoblastomas are larger than 2 cm and may be locally aggressive. ...
Source: Surgical Pathology Clinics - October 7, 2021 Category: Pathology Authors: Fernanda Amary, Adrienne M. Flanagan, Paul O ’Donnell Source Type: research
Osteosarcoma
Diagnosis of osteosarcoma can be challenging because of its diverse histological patterns and the lack of diagnostic biomarkers for most examples. This review summarizes the key pathologic findings of osteosarcoma subtypes (high-grade central, parosteal, low-grade central, periosteal, high-grade surface, and secondary) with an emphasis on describing and illustrating histological heterogeneity to help general pathologists. Differential diagnoses are listed for each entity, and histological subtype and distinguishing features, including molecular genetic findings (eg, MDM2, IDH, H3F3A, FOS, and USP6), are discussed. The revi...
Source: Surgical Pathology Clinics - October 7, 2021 Category: Pathology Authors: Akihiko Yoshida Source Type: research
Benign Cartilage-forming Tumors
Although uncommon in many pathology practices, cartilage-forming tumors represent some of the most frequent primary bone tumors. Diagnosis can be challenging given their variable histologic spectrum and the presence of overlapping morphologic, immunohistochemical, and genetic features between benign and malignant entities, particularly low-grade malignancies. Correlation with clinical findings and radiographic features is crucial for achieving an accurate diagnosis and appropriate clinical management, ranging from observation to excision. Tumors can be characterized broadly by their location in relation to the bone (surfac...
Source: Surgical Pathology Clinics - October 7, 2021 Category: Pathology Authors: Darcy A. Kerr, Nicole A. Cipriani Source Type: research
Malignant Cartilage-Forming Tumors
Chondrosarcomas are heterogeneous matrix-producing cartilaginous neoplasms with variable clinical behavior. Subtypes include conventional (75%), dedifferentiated (10%), clear cell (2%), mesenchymal (2%), and periosteal chondrosarcoma ( (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - October 7, 2021 Category: Pathology Authors: Meera Hameed Source Type: research
Vascular Tumors of Bone
Vascular tumors of bone can be diagnostically challenging because of their rarity and histologic overlap with diverse mimics. Vascular tumors of bone can be categorized as benign (hemangioma), intermediate-locally aggressive (epithelioid hemangioma), intermediate-rarely metastasizing (pseudomyogenic hemangioendothelioma), and malignant (epithelioid hemangioendothelioma and angiosarcoma). Recurrent genetic alterations have been described, such as FOSB rearrangements in pseudomyogenic hemangioendothelioma and a subset of epithelioid hemangiomas; CAMTA1 or TFE3 rearrangements in epithelioid hemangioendothelioma. This review d...
Source: Surgical Pathology Clinics - October 7, 2021 Category: Pathology Authors: Yin P. Hung Source Type: research
